Claim total
$93.39
base $93.39 · payer covered $74.71
The visit
- Class
- Ambulatory
- Code
- 390906007
- Reason
- diagnosis concept Chronic pain82423001
- Start
- 2014-04-29
- Stop
- 2014-04-29
The parties
- Patient
- patient Minnie Glenna Hilpert
- Provider
- provider Forrest Hirthe
- Care site
- care site FAIRVIEW HEALTH SERVICES
- Payer
- payer Medicare
Record id
164073e3-ecac-90a2-58fc-595a08043db1